31.4 Reimbursability and Annual Redetermination Under Title IV-E Foster Care

Cabinet for Health and Family Services

Department for Community Based Services

Division of Protection and Permanency

Standards of Practice Online Manual

Chapter:

Chapter 31-Standards of Practice Regarding Title IV-E, Medicaid and Other Applicable Benefits

Effective:

9/14/2018

Section:

31.4 Reimbursability and Annual Redetermination Under Title IV-E Foster Care

Version:

2

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Legal Authority/Introduction

Procedure

Determines whether the initial placement and all subsequent placements are reimbursable upon redetermination as described in SOP 31.5 Legal Responsibility;

Makes the reimbursability determination for each month in the twelve (12) month period and completes OOHC 1262 IV-E Redeterminationform;

Completes a 'look-back' every twelve (12) months for redetermination to determine that the following seven (7) criterion were met on a month to month basis:

Legal responsibility for the child is with the title IV-E agency;

Court certification within the last twelve (12) months that reasonable efforts are being made to finalize a permanency plan or that reasonable efforts to reunify the child and family are not required as described in SOP;

A court order, which contains the appropriate judicial determination, obtained within one-hundred, eighty (180) days for children removed as a result of a voluntary commitment agreement;

Under age eighteen (18) or under age nineteen (19) if in school and expected to graduate by age nineteen (19).

Practice Guidance

Once eligibility is established, the Cabinet determines for every month that a child is in foster care whether the child’s care was reimbursable by the federal government.

A child may lose and regain reimbursability on a frequent basis depending on changes in the child’s circumstances. Conditions of reimbursability may vary from month to month.

A redetermination occurs every twelve (12) months to establish whether the seven (7) reimbursability criterions are met on a month to month basis.

The procedures for eligibility and reimbursability may occur simultaneously.

The agency may claim title IV-E foster care maintenance payments (FCMPs) for a child placed with a parent in a licensed residential family-based treatment facility for substance abuse for up to 12 months in accordance with requirements in sections 472(j) and 472(a)(2)(C) of the Act. The agency may also claim administrative costs during the 12 month period consistent with 45 CFR 1356.60(c) for the administration of the title IV-E program, which includes such things as case management. A licensed residential family-based treatment facility for substance abuse is not a child care institution (CCI) as defined in section 472(c) of the Act. While the facility must be licensed, there is no requirement that it meet the title IV-E licensing and background check requirements for a CCI.

The agency may claim FCMPs in accordance with the definition in section 475(4)(A) of the Act, which includes such things as the cost of providing food, clothing, shelter, and daily supervision. However, because a licensed residential family-based treatment facility for substance abuse is not a CCI, the agency may not include the costs of administration and operation of the facility in the child’s title IV-E FCMP.

Foot Notes

Footnotes

There are six (6) types of out of home placements that are IV-E reimbursable:

An approved foster family home (includes an approved relative foster home);

A private non-medical group home licensed by the state (a PCC);

A public non-medical group home or child-care facility which has a licensed capacity of less than twenty-six (26) beds;

A licensed private child placing (PCP) provider;

An approved pre-adoptive placement; or

A supervised independent living setting (when the child is eligible as described in procedure 3 (G) in this chapter and section).